Active NPI
Jeffrey D Geddes, PH.D.
- Clinical Psychologist
- Shaw Afb, SC
National Provider Identifier
1457549164
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 8144593-2501
- Practice address
- 420 Polifka Dr
Shaw Afb, SC 29152-5100 - Phone
- (830) 895-4308
- NPI assigned
- Oct 9, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 8144593-2501 | UT | Primary |
Addresses
Primary practice location
420 Polifka Dr
Shaw Afb, SC 29152-5100
Mailing address
420 Polifka Dr
Shaw Afb, SC 29152-5100
Phone (830) 895-4308
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8144593-2501 | UT | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1191888000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1769990400000",
"number": "1457549164",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "420 POLIFKA DR",
"city": "SHAW AFB",
"state": "SC",
"postal_code": "291525100",
"telephone_number": "830-895-4308"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "420 POLIFKA DR",
"city": "SHAW AFB",
"state": "SC",
"postal_code": "291525100",
"telephone_number": "830-895-4308"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GEDDES",
"first_name": "JEFFREY",
"middle_name": "D",
"name_prefix": "Mr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-10-09",
"last_updated": "2026-02-02",
"certification_date": "2026-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "UT",
"license": "8144593-2501",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shaw Afb, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.